Individual provider Active NPI

Quresh Khairullah, MD

  • Nephrology Physician
  • Roseville, MI
National Provider Identifier
1295737831
Registry record updated Feb 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
QK056739 Issued in MI
Practice address
18001 E 10 Mile Rd
Suite 1
Roseville, MI 48066-3803
Phone
(586) 218-5800
Fax
(586) 218-5808
NPI assigned
Aug 12, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X QK056739 MI Primary
Nephrology Physician 207RN0300X 49070 CO

Addresses

Primary practice location

18001 E 10 Mile Rd
Suite 1
Roseville, MI 48066-3803

Mailing address

45640 Schoenherr Rd
Suite B
Shelby Township, MI 48315-6033
Phone (586) 247-4300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
QK056739MIMDNephrology Physician

Interoperability endpoints

  • Direct secure messaging: qureshkhairullah@stclairspe.allscriptsdirect.net

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1123804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455667200000",
    "number": "1295737831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45640 SCHOENHERR RD",
            "address_2": "SUITE B",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483156033",
            "telephone_number": "586-247-4300",
            "fax_number": "586-532-6496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18001 E 10 MILE RD",
            "address_2": "SUITE 1",
            "city": "ROSEVILLE",
            "state": "MI",
            "postal_code": "480663803",
            "telephone_number": "586-218-5800",
            "fax_number": "586-218-5808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAIRULLAH",
        "first_name": "QURESH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-12",
        "last_updated": "2016-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MI",
            "license": "QK056739",
            "primary": true
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CO",
            "license": "49070",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.